POS0798 NUMANO TYPE IIB, INFLAMMATORY PROGRESSION OF DISEASE AND DILATION OF ASCENDING AORTA AND AORTIC ROOT ARE IMPORTANT RISK FACTORS CAUSING AORTIC VALVE INVOLVEMENT IN TA PATIENTS.
Authors: X. Shi
Journal: Annals of the Rheumatic Diseases (2022)

Background Takayasu arteritis (TA) can involve cardiac valves. In Chinese patients with TA, valvular abnormalities were found in 48.9% (201/411) patients[1,2]. Another research showed that cardiac valvular involvements were found in 34.9% (373/1069) TA patients in China[3], and in a recent study, they also found that 64.08% (66/103) of TA patients had valvular damage[4]. In addition, the most common valve involved in TA is the aortic valve, and the most common valvular lesion caused by TA is valvular insufficiency. The incidence of aortic regurgitation in patients with TA has been reported as 33.2% (455/1372) in Japan[5], 21.7% (13/60) in Italy[6], 18.1% (29/160) in Korea[7], and 20.4% (84/411)[1] to 39.8% (41/103)[4] in China. AR can further induce congestive heart failure or arrhythmia, both of which are considered one of the main causes of death in TA patients[8]. Objectives Aortic valve involvement is not uncommon in patients with Takayasu arteritis (TA). The aim of our study was to evaluate the clinical characteristics of aortic valve involvement in TA patients, and to explore the risk factors of aortic valve involvement in TA. Methods In this retrospective study, 174 patients with TA were divided into groups with or without aortic valve involvement. We compared the clinical manifestations, laboratory parameters, and imaging results between the two groups. The logistic regression analysis was used to identify the risk factors of aortic valve involvement in TA patients. Results In our study, a total of 94 TA patients (54.02%) had aortic valvular lesion. The proportion of elevated ESR and elevated high-sensitivity CRP, and ITAS-A score in the aortic valve involvement group were significantly higher than in the non-aortic valve involvement group. 2 patients were found to have the infiltration of Inflammatory cells in surgical specimens of the aortic valve. The Numano type IIb and elevated hs-CRP level were found to be statistically related to aortic valvular lesion in TA patients (6.853 [1.685-27.875], p=0.007; 4.896 [1.646-14.561], p=0.004). Dilation of the ascending aorta and aortic root were significantly associated with aortic valvular involvement in TA patients (4.509 [1.517-13.403], p=0.007; 9.340 [2.188-39.875], p=0.003). Conclusion The Numano type IIb, elevated hs-CRP level, dilation of the ascending aorta and aortic root are risk factors for aortic valve involvement in TA patients. References [1]Li, J., et al., Clinical Characteristics of Heart Involvement in Chinese Patients with Takayasu Arteritis. J Rheumatol, 2017. 44(12): p. 1867-1874. [2]Li, J., et al., The clinical characteristics of Chinese Takayasu’s arteritis patients: a retrospective study of 411 patients over 24 years. Arthritis Research &amp; Therapy, 2017. 19(1). [3]Zhang, Y., et al., Cardiac Valve Involvement in Takayasu Arteritis Is Common: A Retrospective Study of 1,069 Patients Over 25 Years. The American journal of the medical sciences, 2018. 356(4): p. 357-364. [4]Ren, Y., et al., Cardiac valvular involvement of Takayasu arteritis. Clinical Rheumatology, 2021. 40(2): p. 653-660. [5]Watanabe, Y., T. Miyata and K. Tanemoto, Current Clinical Features of New Patients With Takayasu Arteritis Observed From Cross-Country Research in Japan. Circulation, 2015. 132(18): p. 1701-1709. [6]Vanoli, M., et al., Takayasu’s arteritis: A study of 104 Italian patients. Arthritis &amp; Rheumatism, 2005. 53(1): p. 100-107. [7]Lee, G.Y., et al., Cardiovascular manifestations of Takayasu arteritis and their relationship to the disease activity: Analysis of 204 Korean patients at a single center. International Journal of Cardiology, 2012. 159(1): p. 14-20. [8]Kwon, H.W., et al., Aortic valve replacement surgery for a case of infantile Takayasu arteritis. Korean Journal of Pediatrics, 2012. 55(7): p. 254. Disclosure of Interests None declared